Bradley J Dexter, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

10833-125 Issued in WI

Practice address

5650 N Green Bay Ave Ste 205
Glendale, WI 53209-4446

Phone

(773) 425-8823

NPI assigned

May 5, 2022

Last updated

Feb 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Bradley J Dexter, Ma, LPC Professional name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cornerstone Counseling Services, Inc

  dba LifeStance Health

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1629713433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5650 N GREEN BAY AVE STE 205",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532094446",
            "telephone_number": "608-286-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5650 N GREEN BAY AVE STE 205",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532094446",
            "telephone_number": "773-425-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEXTER",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-05",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "10833-125",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "10833-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRADLEY",
            "last_name": "DEXTER, MA, LPC",
            "middle_name": "J",
            "credential": "MA, LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• B. Hal Dessel, LCSW, CADC III
• Kari Lynn Di Fonzo, LCSW,
• Kayla Diesner
• Digitrace Care Services, Inc
• Dimitrios P Bousounis MD
• Divine Horizon Pmhnp Services, LLC

• Professional Counselor in Glendale, WI
• Providers in Glendale, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.